{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T14:19:05Z","timestamp":1780755545778,"version":"3.54.1"},"reference-count":5,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,7,10]],"date-time":"2025-07-10T00:00:00Z","timestamp":1752105600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"Background<\/jats:title>Acute stent thrombosis (AST) is a rare but serious complication occurring within 24\u2005h after percutaneous coronary intervention (PCI), typically caused by insufficient antiplatelet therapy, stent under-expansion, or malapposition. Tissue prolapse (TP) within the stent is less frequently reported as a cause of AST and lacks direct imaging-based evidence.<\/jats:p><\/jats:sec>Case summary<\/jats:title>We report a case of a patient with acute ST-segment elevation myocardial infarction (STEMI) who experienced recurrent ST-segment elevation 1\u2005h after primary PCI. Coronary angiography revealed mid-stent occlusion, and intravascular ultrasound (IVUS) identified tissue prolapse with echogenic features consistent with fibrolipidic plaque. The initial stent was appropriately sized and well-deployed, and activated clotting time (ACT) indicated adequate anticoagulation. In the absence of traditional risk factors for AST, the large-volume tissue prolapse was considered the likely cause. Balloon angioplasty failed to resolve the prolapse, so an additional stent was implanted at the site. After this intervention, no further thrombotic events occurred.<\/jats:p><\/jats:sec>Conclusion<\/jats:title>This case provides clear intravascular imaging evidence that tissue prolapse can induce AST. For cases of early stent thrombosis with angiographic haziness and no signs of dissection or malapposition, clinicians should suspect tissue prolapse. Intravascular imaging facilitates accurate diagnosis and helps guide treatment. Further research is warranted to define high-risk features of tissue prolapse\u2014such as volume, protrusion, and composition\u2014to establish thresholds and interventional criteria that may prevent AST.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fcvm.2025.1637979","type":"journal-article","created":{"date-parts":[[2025,7,10]],"date-time":"2025-07-10T05:31:15Z","timestamp":1752125475000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Tissue prolapse-induced acute stent thrombosis: a case report and intravascular imaging-based insight"],"prefix":"10.3389","volume":"12","author":[{"given":"Weifeng","family":"Zhang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shengqi","family":"Jia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanmin","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haiyan","family":"Jia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,7,10]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"100971","DOI":"10.1016\/j.jscai.2023.100971","article-title":"SCAI expert consensus statement on management of in-stent restenosis and stent thrombosis","volume":"2","author":"Klein","year":"2023","journal-title":"J Soc Cardiovasc Angiogr Interv"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1499","DOI":"10.1016\/j.jcin.2016.05.043","article-title":"Prevalence and clinical impact of tissue protrusion after stent implantation: an ADAPT-DES intravascular ultrasound substudy","volume":"9","author":"Qiu","year":"2016","journal-title":"JACC Cardiovasc Interv"},{"key":"B3","doi-asserted-by":"publisher","first-page":"e003726","DOI":"10.1161\/CIRCINTERVENTIONS.115.003726","article-title":"Clinical impact of suboptimal stenting and residual intrastent plaque\/thrombus protrusion in patients with acute coronary syndrome: the CLI-OPCI ACS substudy (Centro per la Lotta Contro L'Infarto-optimization of percutaneous coronary intervention in acute coronary syndrome)","volume":"9","author":"Prati","year":"2016","journal-title":"Circ Cardiovasc Interv"},{"key":"B4","doi-asserted-by":"publisher","first-page":"342","DOI":"10.1016\/j.jjcc.2016.12.007","article-title":"Relationship between yellow plaque grade and tissue protrusion after stent implantation: a coronary angioscopy study","volume":"70","author":"Miyoshi","year":"2017","journal-title":"J Cardiol"},{"key":"B5","doi-asserted-by":"publisher","first-page":"646","DOI":"10.1016\/j.ijcard.2011.11.092","article-title":"Impact of tissue prolapse after stent implantation on short- and long-term clinical outcomes in patients with acute myocardial infarction: an intravascular ultrasound analysis","volume":"166","author":"Hong","year":"2013","journal-title":"Int J Cardiol"}],"container-title":["Frontiers in Cardiovascular Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2025.1637979\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,10]],"date-time":"2025-07-10T05:31:16Z","timestamp":1752125476000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2025.1637979\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,10]]},"references-count":5,"alternative-id":["10.3389\/fcvm.2025.1637979"],"URL":"https:\/\/doi.org\/10.3389\/fcvm.2025.1637979","relation":{},"ISSN":["2297-055X"],"issn-type":[{"value":"2297-055X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,10]]},"article-number":"1637979"}}